全数字化乳腺X经线成像技术对乳腺疾病的诊断价值  

Clinical evaluation of full-field digital mammography and breast imaging reporting and data system no breast diseases

作　　者：李继光[1] 黎庶[2] 刘群[1] 赵婷婷[1] 

机构地区：[1]中国医科大学附属第一医院肿瘤学教研室,沈阳110001 [2]中国医科大学附属第一医院放射科,沈阳110001

出　　处：《中华外科杂志》2007年第7期464-466,共3页Chinese Journal of Surgery

基　　金：辽宁省医学科技创新工程资助项目(辽卫函字[2004]378号)

摘　　要：目的探讨全数字化平板乳腺成像(FFDM)技术的临床应用价值。方法 2004年1月1日至2005年12月31日共收治乳腺癌、乳腺纤维腺瘤、导管内乳头状瘤及乳腺病患者831例,包括871个病灶。FFDM 的诊断标准采用美国放射学会推荐的乳腺影像报告和数据系统(BI-RADS),初步认定Ⅳ级及Ⅴ级为恶性诊断,Ⅰ～Ⅲ级为良性诊断。结果 FFDM 对该组乳腺疾病病灶性质诊断的敏感性为80.9%,特异性为90.0%,阳性预测率为88.4%,阴性预测率为83.3%,准确率为85.5%。影像学诊断为Ⅴ级的病例中乳腺癌占97.7%(260/266),Ⅳ级中占67.8%(82/121),在Ⅰ～Ⅲ级中尚有16.7%(81/484)为乳腺癌。结论乳腺 X 线诊断为Ⅴ级时,建议用手术活检来明确诊断,Ⅳ级时应积极建议手术活检或真空辅助旋切活检。要慎重对待Ⅰ～Ⅲ级的诊断,应由临床医师根据其他临床证据及相关因素决定处理意见。Objective To evaluate the values of full-field digital mammography （FFDM） and breast imaging reporting and data system （BI-RADS） on breast diseases. Methods Eight hundreds and thirty-one patients with 871 focuses were analyzed who underwent imaging examinations with FFDM before operation during January 1 2004 to December 31 2005. All patients received operation and had identified pathological diagnosis including breast cancer, breast fibroma, intraductal papilloma and breast disease. The radiological diagnosis followed BI-RADS suggested by American College of Radiology. Results The imaging diagnostic sensitivity of overall focuses was 80. 9%, the specificity was 90. 0%, the positive predictive value was 88. 4% ,the negative predictive value was 83.3% and the diagnose accuracy was 85.5%. Two hundreds and sixty cases （97.7%） were pathological diagnosed breast cancer in BI-RADS category Ⅴ, 67. 8% （82/ 121 ） in BI-RADS category Ⅳ and 16. 7% （ 81/484 ） in BI-RADS category Ⅰ - Ⅲ. Conclusions When the radiological diagnosis is BI-RADS category Ⅴ, surgery biopsy is the option. To category IV focuses, surgery biopsy or stereotactie vacuum-assisted biopsy should be suggested. As to category Ⅰ - Ⅲ focuses, the management should be prudent, and other factors should be considered including the social and economic factors.

关 键 词：乳房平板摄像术 乳腺肿瘤 信息系统 X线成像技术 

分 类 号：R655.8[医药卫生—外科学]